Synchronous Renal Cell Carcinoma Metastasis Masquerading as Subcutaneous and Thyroid Swellings, Diagnosed on FNAC- A Case Report

Renal cell carcinoma (RCC) is one of the most aggressive genitourinary cancers accounting for about 3% ofadult malignancies. The most common symptoms at the time of presentation are hematuria, lion pain and/oran abdominal mass. However, about a quarter of patients with RCC present with metastatic disease; withlungs, lymph nodes and bone as prototypical metastatic sites. RCC notoriously may metastasize to bizarrelocations like subcutaneous tissue and thyroid. We report a case of simultaneous subcutaneous and thyroidsynchronous metastasis of RCC in an 80year old female diagnosed on FNAC.

Nonthyroidal metastatic lesion in thyroid: A missed diagnosis and a lesson learnt

Background: Blood supply to the thyroid is relatively high when compared to that of liver. Despite this documented metastatic deposit in thyroid remains a rarity. Synchronous nonthyroidal metastatic deposit in thyroid from a lung primary is relatively rare. Metastasis to thyroid portends to poor prognosis, and hence a metastatic deposit has to be excluded in any suspicious lesion of thyroid. Materials and Methods: Details of a rare presentation of a malignant thyroid lesion, a secondary deposit from an asymptomatic primary papillary adenocarcinoma of lung, who had presented to this tertiary care center was retrieved and analyzed. Results: Patient with an initial diagnosis of papillary carcinoma on FNA was taken up for total thyroidectomy and cervical lmphadenectomy. HPR was mucinous carcinoma of thyroid with high lymph nodal metastasis. In view of the exrathyroidal disease an adjuvant external beam radiotherapy was considered for him. Unfortunately, the radiotherapy planning CT scan revealed left sided lung lesions with pleural effusion which was proved to be papillary adenocarcinoma of lung on biopsy, with metastases to thyroid. He was treated with chemotherapy but he succumbed to his illness 9 months from the date of diagnosis. Conclusion: Although encountered rarely, metastatic lesions in thyroid from nonthyroidal primaries need to be excluded while evaluating thyroid lesions

A Case of Squamous Cell Carcinoma of Cervical Esophagus with Metastasis to Thyroid Gland

Despite thyroid is a highly vascularized organ, clinically significant metastatic spread to the thyroid is considered uncommon. There is a reported incidence of up to 24.0% metastases to the thyroid in autopsy series. The most frequently noted primary sites are the kidney, breast, and lung. The metastatic spread of alimentary tract is quite rare, and the majority comes from the colo-rectum. We present a case of squamous cell carcinoma of the cervical esophagus presenting as thyroid nodule in an apparently healthy 54 year-old male patient. This might be the first case of esophageal carcinoma metastases to the thyroid presenting in South Korea.

Metastatic squamous cell carcinoma in autotransplanted thyroid: A diagnostic dilemma

Metastasis to the thyroid is uncommon. Mostly, they are tumors that originate in the lung or head or neck. Metastases from breast or kidney carcinomas and metastatic melanoma have also been reported. Autotransplantation of benign thyroid tissue is a surgical procedure designed to achieve normal thyroid hormonal status following surgery. Metastasis into autotransplanted thyroid tissue has not been reported earlier. We report a case of squamous cell carcinoma (SCC) metastatic to autotrasplanted thyroid diagnosed on fine-needle aspiration. Further workup revealed a primary oral cavity SCC.

Metástasis en troides de tumores primarios extratroideos / Thyroidal metastasis of primary extrathyroidal tumors

Antecedentes: las metástasis en tiroides son infrecuentes, pocas veces diagnosticadas antes de la cirugía; sin embargo, las autopsias muestran una frecuencia que oscila entre el 1 y el 24%. Objetivo: presentar nuestra estadística de metástasis en tiroides de tumores extratiroideos y citar una metástasis a los 23 años del tumor renal primario. Material y métodos: estudio retrospectivo estadístico sobre 1000 tiroidectomías y sus hallazgos histológicos, en un Hospital General. Resultados: en 1000 tiroidectomías, hallamos 3 metástasis extratiroideas, 2 de riñón (un paciente masculino de 70 años con primario 9 años antes y una mujer de 73 años con primario 23 años antes) y uno de útero (pacientede 74 años con primario de 5 años antes). La metástasis del carcinoma renal fue la más frecuente. Conclusión: la localización de metástasis en tiroides es poco habitual pero debe ser considerada especialmente en aquellos enfermos con antecedentes de carcinomas.

Background: Although metastasis in the thyroid gland are rare and infrequently diagnosed, they can be found in 1 to 24% of all autopsies. Objective: to present our series of thyroidal metastasis, of extra thyroid primary tumors and to report one case of metastasis 23 years after a primary renal tumor. Material and methods: retrospective study of 1000 thyroidectomies and the histological findings in a General Hospital. Results: in 1000 thyroidectomies, we found 3 metastases of extrathyroid cancer, 2 renal (male 70 years old with 9 year prior primary, female 73 years old with a primary 23 years before) and a female 74 years old with a primary of uterus operated 5 years earlier. The renal metastases in thyroid were the most common. Conclusion: the localization of metastases in thyroid are unusual, but should be considered in patients with history of malignancy carcinomas.

Thyroid metastasis of bladder transitional cell carcinoma

The thyroid gland is a rare site for cancer metastasis. We report a 75-year-old man who was referred with a history of hematuria and generalized bone pain for the past few months. He had a past history of partial left lobe thyroidectomy for follicular adenoma. Subsequently he was referred for a thyroid mass and a subtotal thyroidectomy showed a poorly-differentiated carcinoma. On the latest admission, the patient underwent resection of a bladder tumour with malignant histology and an immunohistochemical profile of CK7+/CK20+/34 Beta E12+/CEA-/PSA-. Re-examination of thyroid sections with immunohistochemical stains revealed the malignant cells to be CK7+/CK20+/34 Beta E12+/CEA-/TTF1-. The findings were compatible with metastasis of the bladder transitional cell carcinoma to the thyroid gland.Scans revealed multiple liver and bone metastases. The patient died 2 months after the diagnosis.

Primary cardiac sarcoma with metastases to thyroid and brain.

Primary cardiac sarcomas are extremely rare with only a few large case series and isolated case reports in the literature. In spite of their aggressive nature with high chances of local recurrence and distant metastases, these tumors and their treatment strategies remain incompletely defi ned. We report an unsuspected case of primary cardiac pleomorphic undifferentiated sarcoma in a 52-year-old female who presented with progressive dyspnea and palpitation. In the postoperative period, she was detected to have secondaries in brain and thyroid, confirmed thereafter, by fine-needle aspiration cytology.

A Case of Thyroid Metastasis Originating from Early Gastric Cancer

We report a rare case of thyroid metastasis from early gastric cancer with lymph node metastasis in a 63-yr old woman. She was diagnosed with metastatic adenocarcinoma one and a half years after distal subtotal gastrectomy, by fine needle aspiration (FNA) using thyroid sonography. Thyroid metastasis from gastric cancer is extremely rare, and this case is particular in that it is the first report of thyroid metastasis from early gastric cancer.

Severe Hypothyroidism Induced by Thyroid Metastasis of Cholangiocarcinoma / Journal of the Korean Cancer Association, 대한암학회지

We report a case of severe hypothyroidism in a cholangiocarcinoma patient with metastasis to the thyroid gland. A 58-year-old man was admitted for upper abdominal discomfort and multiple palpable neck nodules. Abdominal computed tomography (CT) demonstrated the presence of a 4.7-cm tumor in the right hepatic lobe, and core needle biopsy revealed it to be cholangiocarcinoma. Neck CT showed a diffuse, low attenuation thyroid gland, and fine-needle aspiration (FNA) demonstrated metastatic adenocarcinoma. Thyroid function tests were initially normal, but the size of the thyroid gland decreased and severe hypothyroidism developed after chemotherapy was implemented for cholangiocarcinoma. In a patient with malignant disease and a goiter, the possibility of a metastatic tumor involving the thyroid should be seriously considered. Metastatic thyroid cancer and thyroid dysfunction are probably infrequent, but diagnosis is important in the institution of appropriate therapy.

Metastatic Renal Cell Carcinoma to the Thyroid Gland / 대한내분비외과학회지

A 53-year-old female presented with a left-sided thyroid nodule 18 years after left nephrectomy. She did not remember the cause of the nephrectomy and the medical records were all lost. On examination there was non-tender, firm and fixed mass lesion on the left thyroid area. Fine needle aspiration of the nodule revealed carcinoma of the clear cell type. A well-enhanced 2 cm sized mass was detected at the pancreas tail on the abdominal CT. She underwent distal pancreatectomy for the pancreas lesion and both left lobectomy and isthmectomy for the thyroid mass. Intraoperative frozen biopsy revealed both masses as clear cell carcinoma of the same type. She was discharged on the 11th postoperative day and no other treatment such as chemotherapy and radiation therapy was done. At 6 month follow up, she was healthy without any evidence of recur-rence.

A Case of Renal Cell Carcinoma with Thyroid Metastasis / 대한내분비학회지

Metastatic thyroid cancer is uncommon but must be distinguished from primary thyroid cancer because of the differences in management and prognosis. Although renal cell carcinoma is one of the most common tumors that metastasize to the thyroid gland, such a case has never been reported in Korea. We describe the first case of metastatic renal cell carcinoma in the thyroid gland. A 66-year-old man presented with a neck mass detected about 6 weeks previously. He had undergone left nephrectomy due to renal cell carcinoma 8 years before and had remained disease-free thereafter. Computed tomography of the neck showed a 5 cm-sized thyroid mass. Fine needle aspiration cytology revealed some malignant cells containing intranuclear inclusions which were assumed to be papillary thyroid carcinoma. The patient underwent total thyroidectomy. Histologic diagnosis of the thyroid mass was metastatic renal cell carcinoma and further evaluation with chest computed tomography showed two enlarged mediastinal lymph nodes suggesting metastases. The previous history of malignancy should be scrutinized when managing a thyroid mass in patients with a prior or concomitant malignancy, and the possibility of metastasis should be carefully considered.